| NPI | 1043764897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH EDWARDS Therapist 214-662-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180010430) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2016-08-10 |